Frontline mental health services desperate for action
The Association of Salaried Medical Specialists says frontline mental health workers are overwhelmed by skyrocketing demand and have seen no meaningful progress despite the promises of the 2018 mental health inquiry.
In assessing progress on the recommendations from the inquiry, the Mental Health and Wellbeing Commission describes frustration over the pace of change and the speed at which funding is being delivered. It suggests some progress has been made but points to an urgent need for an overarching plan.
ASMS Executive Director Sarah Dalton says while the Commission’s report is welcome, it does not reflect the dire situation facing patients and those trying to provide services on the ground.
“I think staff would argue that there has been no meaningful change to the system at all, with acute and community psychiatric services completely overwhelmed and in crisis,” she says.
ASMS recently asked psychiatrist members to detail their experiences. Below are a few of their comments.
“Increasingly we are seeing people turning up later into the course of their illness, or patients who were already on the waiting list turning up at the emergency department, because the wait list is months long. We are seeing things reaching a crisis point for people more often. Usually, we’d be able to intervene earlier and stop someone from getting to crisis point, but we can’t do that if we don’t have enough staff”.
“We haven’t increased inpatient beds in 20 years and the population has increased, so there needs to be more sub-acute beds. A lot of our beds are blocked by people because there is no accommodation and then we can’t get crisis patients in or they come in later and so they’re sicker”.
“We are highly under-resourced – there just aren’t enough staff, not enough resources. There is huge demand, really, really high need and we’ve been significantly impacted not just by high rates of severe mental illness but significant deprivation, homelessness, poverty, substance abuse issues, and not being able to get resources to address those needs”.
ASMS believes the long-term lack of workforce planning and investment to match the growing demand for mental health services has clearly compounded the problems.
“We know we’re well short of psychiatrists but there’s been no assessment of how many we actually need to provide a quality service and what is urgently needed is a kind of national ‘job sizing’ of the psychiatrist workforce”.
Sarah Dalton adds that improvements to mental health and wellbeing go hand in hand with social determinants such as poor housing and poverty and that is where many of the remedies lie.
“This is especially important with mental health where there isn’t enough supported accommodation, and many vulnerable patients are homeless. They fall through the cracks because they are not in a position to access healthcare”.